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Arquivos Brasileiros de Oftalmologia
On-line version ISSN 1678-2925
MACHADO, Danuza de Oliveira et al. Posterior scleritis: clinical features, systemic association, treatment and evolution of 23 patients. Arq. Bras. Oftalmol. [online]. 2009, vol.72, n.3, pp.321-326. ISSN 1678-2925. http://dx.doi.org/10.1590/S0004-27492009000300008.
PURPOSE: To document the clinical features, systemic association, treatment and evolution of 23 patients with posterior scleritis evaluated in the Uveitis service of the Federal University of Minas Gerais. METHODS: 23 patients were identified with the diagnosis of posterior scleritis. Signals and symptoms, visual acuity, B-mode ultrasonography signals, systemic associations, treatment and evolution were described and analyzed. RESULTS: Sixteen patients were female and seven were male with mean age of 44,7 years. Posterior scleritis occurred in association with anterior scleritis in 10 patients, unilateral involvement in 17 patients and simultaneous bilateral involvement in 6 patients. Posterior scleritis in association with systemic disease occurred in 8 patients (Cogan's syndrome, TBC, Wegener, Herpes simplex and Zoster, Apergilosis, inflamatory bowel disease and Sarcoidosis). The main symptoms were ocular pain and decrease of visual acuity and the main signal was retinal serous detachment. Increase of thickness choroidal tissue was the main signal in B-mode ultrasonography in 18 patients and the principal kind of treatment was the use of systemic corticosteroids. Only 4 patients required systemic immunosuppressive drugs. CONCLUSIONS: Posterior scleritis still represents a diagnostic challenge and is often associated with life threatening systemic disease and vision threatening ocular complications. Knowledge of posterior scleritis may aid in determining timely and accurate diagnosis and treatment of both ocular and any systemic conditions associated, thus decreasing morbidity and mortality. Elevated suspicion rate is always required to detect this condition.
Keywords : Scleritis; Sclera [ultrasonography]; Retinal detachment; Pain; Prednisolone [therapeutic use].